Organization
DILLON COMPANIES LLC
Active
Other names
King Soopers Pharmacy #123
Organization subpart
No
Provider details
NPI number
Authorized official
LYSETTE SEILHAMER (MANAGER OF PHARMACY LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
10406 MARTIN LUTHER KING BLVD, DENVER, CO 80238
(720) 531-6371
(720) 531-6374
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PDO.1680000141
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346797867
—
CO
01
—
2163973
PK
—
Enumeration date
09/01/2016
Last updated
12/09/2022
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